Breaking down barriers: how do we evolve UK healthcare?

Hello and welcome to the second series of Catapult Network Supercharging Innovation podcast. I'm Catherine Bennett, CEO of the High Value Manufacturing Catapult and former chair of the Catapult Network. Our network is made up of nine world-leading technology and innovation centres, established and partially funded by InnovateUK. This supercharging innovation series explores how the UK must break down barriers to solve national and global challenges and how this could be realised through the power of science, innovation and technology. In the fourth episode of this series, our expert panel will be discussing how we can evolve UK healthcare. Today, you'll hear from some of our most knowledgeable experts across the network. A fellow Catapult CEO, Chris Malloy, chairs the discussion alongside our colleagues Jacqueline Barry and Aaron Harish. We also have a very special guest joining Professor Dame Anna Dominček, Chief Scientist for the Scottish Government and Regius Professor of Medicine at the University of Glasgow. Can we build health resilience in a post-pandemic world? What are the best examples of UK leadership in health innovation? How can we increase the availability and accessibility of new treatments for patients who need them? I'll pass over to Chris to get the discussion started. Thanks very much, Catherine. There are a few industrial sectors that come closer to each and every one of us than health. It is in our homes, our high streets, our hospitals and our hearts for our families, our friends and our co-workers. There are no shortage of strong opinions that we have ourselves and share and listen to around the state of health. How we look after our own health and how others help us look after our health. It was brought into sharp focus by the pandemic, of course, but it is in our every day and our tomorrows. Be that through our ever-increasing global age, our over-increasing obesity rates, our rates of mental health and the dramatic rise of microbial resistance, just to name a few major health care challenges that we see worldwide. The catapults in the UK work for and with industries who seek productivity through innovation, and innovation, of course, is the adoption of proven inventions. My name is Chris Malloy, and I'm the Chief Exec of Medicine's Discovery Catapult, and I'm very happy to be joined today by my catapult colleagues, Dr. Jacqueline Barry, Chief Clinical Officer at the Selengy Therapy Catapult, Dr. Arun Harish, Chief Strategy Officer at CPI, part of the High Value Manufacturing Catapults, and our very special guest today, Professor Damiana Dominicek, Regis Professor of Medicine at the University of Glasgow, and Chief Scientist for Health in the Scottish Government. We hope that this group brings a unique combination of inventors, industrialisers, and adopters of health care innovation, and look forward to talking with each other and in front of you for the next 30 to 40 minutes about some of the barriers that there are to health care innovation, some of the barriers there are to the adoption of that innovation, and some of the things that we might and will do over the next years to drive health care into a new model, tomorrow's model, to meet today's and tomorrow's conditions. So welcome, all of you. Thank you very much indeed for joining us today, and I will start off with a question, and as you answer that first question, if you could briefly just describe what your organisation does that will help those listening today to understand the perspective that you come from, the skills that you've got, and the ideas that you and your organisation has. So the question I'd like to start with, the UK is creating the next generation of precision medicines, therapies, diagnostics, and health technologies to fight and ultimately prevent disease, and I'd like to know from you where you're seeing strong examples of UK leadership in that sector, and I'll start with Anna, if I may. Anna, you are very welcome. Thank you very much, Chris. So in my first role you mentioned of the religious professor of medicine, I contributed to Scotland and Glasgow, University of Glasgow, winning a very large precision medicine grant from UKRI, which was 39 million from UKRI, topped up by industry partners into above 80 million, which contributed to building the living laboratory for precision medicine in Glasgow in the biggest hospital in Scotland, Queen Elizabeth University Hospital, in govern the area of probably one of the biggest areas of deprivation in United Kingdom. This is where industry comes together with NHS and academia to work on precision medicine in various aspects, and I think over the last few years our definition of precision medicine, partially because of this work and many other international ideas, movements, discoveries, have moved broader than just the right drag for the right patient at the right time, but into data, digital, AI, machine learning, and therefore this living laboratory for precision medicine brings companies both UK and international to work closely with clinicians to have this what's called short white coat distance, although we no longer wear white coats in hospital, and I think it's been really helpful investment to bring job creation, to bring what I call triple helix academia, NHS and industry together in Scotland. My second hat, which is chief scientists for health, for Scottish government, means working with stakeholders across Scotland, so that's not Glasgow, that's all of Scotland. I no longer say Glasgow, Glasgow, Glasgow, I now say all of Scotland, and part of activities for precision medicine has been a 10 million initiative that commenced around 2021, so during COVID to fund four precision medicine projects, three in Edinburgh, one in Dundee on type two diabetes, that's very, very interesting Dundee project, and two projects in Edinburgh that look at multiple sclerosis that you know is more common in Scotland than the rest of UK. There is this Northern gradient that looks at something unusual that is precision medicine in acute A&E situation, very unique project, and precision medicine in liver disease, and these four projects together are still in progress, but we've seen really interesting results coming through, and we've asked these teams to publish in our new precision medicine journal, the Prisms Precision Medicine published by Cambridge Press, so you would be able hopefully to see more detail about these projects soon. Thanks very much Anna, so this is a real frontline medicine being reviewed and reported on to not just folks in the UK here, but worldwide too, so getting that evidence base from areas where disease is prevalent to those out there who can help treat and manage it. Thank you. Jackie, from the cell and gene therapy catapult, what do you see as some some great areas of of UK advancement and success? Well I suppose advanced therapies or cell and gene therapies, the terms are used interchangeably, offer the potential for a single one-off treatment and a potential cure for patients long-term, so they offer significant savings, not only the beneficial for the patients, but they actually also offer significant savings for the NHS potentially, both in terms of cost, but I'd say more importantly, freeing up resources within the NHS. I think we've got a number of examples of UK leadership in this space, the least only last week there was a press release, there's been just under £80m investment in the advanced therapy treatment centre network, which has been in operation for the last six years. This is a network of centres across the whole of the UK, coordinated by cell and gene therapy catapult. When we work with industry, the triple helix that Anna talked about, we work with academia, industry, NHS to ensure that the NHS is ready for the adoption of these therapies, because albeit they are one-off therapies potentially, they're quite difficult to implement. You may need to take cells from a patient, you need to coordinate that with the manufacturing slot that may well be on the other side of the world, you then have to coordinate a patient's immunosuppression before they receive their own cells back, so it is quite complex for the NHS to deal with. And if there wasn't that close collaboration between industry and the NHS, much closer than what you would normally see, where normally the manufacturer produces its little white pill, they hand it over to the NHS, the pharmacist dispenses it, and that's the interaction, has to be much closer. So the advanced therapy treatment centre has been working for the last six years to build processes and systems, and we'll continue that over the next four years, but the funding is coming from NIHR through our UK, so there'll be a much greater emphasis on clinical trials and how we improve clinical trials here in the UK for advanced therapies. So that's one bit, but because this is such a new field and there's so many touch points, I think also you'd want to consider what the manufacturer of it here in the UK, and importantly, the release and approval of these products here in the UK. There's a gene therapy for beta-phalosemia and sickle cell disease called caskevi, it's a CRISPR-edited technology, so obviously the CRISPR editing allows you to precisely edit genes, and there's a platform for the treatment of many, many inherited genetic disorders, and in November last year, the UK was the first to globally approve a CRISPR-edited product, which was actually manufactured here in the UK actually in Edinburgh, just behind Rome, and sat. So not only did we work with Vertex, the producers, Rosalind CT, with the manufacturers of it, to manufacture the product, but the MHRA were actually ahead of the field and approved this. So I think that really shows the close interaction of the ecosystem here in the UK, and I think we have that real advantage. We're quite a small country, but we're actually very knowledgeable in this field, and I think if we can use that capability and connectivity, the UK can stay ahead and show the leadership that we're already showing. Thanks Jackie. Adam, from what you're seeing across medical or health technologies as well as other areas of process improvement, what's your perspective on where the UK is playing well in and across the health sector and innovation? Thank you Chris. At CPI, we tend to focus mostly on developing, proving, and scaling up of novel manufacturing technologies for both health tech and medicines, and we make them at the appropriate quality and quantity to feed into clinical validation stages of GMP, for example, for medicines. And next generation medicines utilizing new modalities are showing tremendous potential, we believe, to treat, to prevent and cure disease. Take nucleic acid therapies, for example, both mRNA as well as oligonucleotides, from vaccines to novel oncology therapies to treating other rare diseases, including autoimmune or neurological. These new modalities are here to stay, and they are growing very rapidly. Early clinical trials are promising some products coming into the marketplace. So CPI, we've worked very closely with the UK Vaccines Task Force during the pandemic to look at how UK could build capability in mRNA based vaccines, and this led to the establishment of our RNA center of excellence in Darlington, which is now a GMP certified facility. And through this RNA center of excellence, we support companies looking at scaling up of their RNA technologies towards clinical trials. And I think we're uniquely positioned in this space because we can produce both the RNA as well as the lipid nanoparticles that carry them. And in close collaboration with yourselves, Chris, through the MDC Medicine Discovery Catapult Imperial College, University of Strathclyde and University of Liverpool, we are also leading the intracelular drug delivery capability center of excellence for the UK, which will drive innovation development in nanotherapeutic drug delivery systems, which will also revolutionize how some of these next generation modalities are delivered to difficult to reach parts of the human body. So these are all world-class, in my opinion, and in some pockets, world-leading. So they naturally position UK as a leading country in driving forward some of these innovations. And more recently, we announced the setting up of our oligonucleotide manufacturing innovation center of excellence, co-located with our medicines manufacturing innovation center in Glasgow. On HealthTech, for example, we're convening companies to look at oncology diagnostics as a priority. How do we drive the next generation of oncology diagnostics and early diagnosis of cancer, for example, which would have a very significant benefit to both the patient and the care providers. Colleagues, what I'm hearing from you and we experience also the Medicine Discovery Catapult is a future environment where medicines and health technologies are becoming more complex. They are becoming more digitally enabled. They are becoming more strategic and more specific as time goes on. And this is changing the relationship, in some cases, as Jackie very rightly said, between industry and the health system, not just as a provider of a product or service at a distance, but a much more closely engaged member of the health care community, working very much more closely with health care providers. And that paints, obviously, a more inventive and one hopes more productive health care system for all of us. What I'd like to look at is the sort of counterargument to that at the moment and say, you know, where are the barriers? Because this all sounds as though it's, you know, yes, highly impressive, highly inventive, highly innovative. But we see from health systems around the world where health costs are increasing, where, you know, in some cases, life expectancy, despite very high health care costs, is decreasing. I'd just like to go through some of the barriers that you and your industrial community, for those catapult colleagues, and also those in the health care system for Anna, with whom I will start. What are you seeing as the barriers sometimes to the adoption of these innovations or the ability, I'm sure there's no lack of willingness, but the ability to take these things on and make the future different. Anna. I think this is a really important question. So we looked at the journey of innovation from discovery science through various stages of translation to adoption. And there is no dubiety at all in my mind and many of my colleagues that the adoption is the most difficult step. You got it absolutely right. This is where lots of innovations that would be wonderful in our health service or other health services just doesn't happen. And there are many barriers financially already mentioned. Sometimes it's just so expensive that health service is not able to adopt it at that time until it becomes cheaper. But there is also a risk appetite. And a risk appetite is an interesting aspect. To take a risk doesn't cost money, but requires right people in right places, I think, throughout our systems. So I am hugely interested in adoption to the NHS, although I understand that companies, SMEs, other companies need adoption to any health system. I think, as you rightly said, health systems around the world all have to change, because we can't carry on as we're doing now. And one of the huge things we have to do is to move to the left-hand side, i.e., to prevention. And precision medicine offers a fantastic way to move to prevention through early diagnostics for cancer and everything else. So much earlier interventions that are cheaper and better, vaccines that Aaron already mentioned, which is a huge preventative measure for our populations. And only that brave, high-risk appetite will move us to the left, will move us from spending all the money in last year of life, rather than on preventative activities. I think it is also the regulation that is another barrier. Sometimes, particularly in health, we want to prevent things that could be dangerous for patients. So in a very good reasoning, our regulation starts inhibiting progress, inhibiting translation and adoption. And I think one recent example we have spotted is in AI and machine learning, where every time there is improvement in the model, it has to be re-submitted for agreement that it hasn't changed significantly. So that gives an example that regulation developed in good intentions could stop progress of research and innovation for our NHS and other health systems. So I think we need to work together across the world internationally. This isn't, I think, for Scotland, even whole UK. This needs to be international will and wish to fight with these barriers, to reduce the barriers. Of course, safety is first for patients in health always, but are we overdoing that safety through our risk appetite being too low? And my last maybe mention is that you said rightly, you need to partner with industry. We need to learn at all levels. For me, it would be Scottish Government, health in Scottish Government. I would like us to partner with industry. I would like partnerships directly with NHS and universities. I would like almost pan-Scottish partnerships with industries where it's appropriate. And I think the appetite for this is now developing. And this is the only way we need to learn that talking to industry is absolutely essential, that you can't collaborate without this proper partnership type of discussion and that this is not conflict of interest at all. This is helping patients together. Jackie, what do you see as some of the barriers to the adoption of these very advanced medicines that you're helping many companies create now that can address lifelong diseases in a very small number of doses? If I can hold that question, I'm going to come back to what Ana was saying. And I think I absolutely agree with Ana. Within the ATTCs, we had a 70 strong industry advisory group from SMEs all the way up to all the large pharma. The lack of competition in that group was tremendous. It really was a collaborative spirit to work together to overcome these barriers. You had companies releasing the same type of products, same parties working together to overcome barriers, working together to look at how we could streamline contracting, clinical trials, whatever. So I think Ana's right. I think especially in a new field such as this, make best potential of it. People are willing to work together and it will save everyone time, effort. It will drive standardisation. So I want to really reinforce that. I totally support that. In terms of the barriers, same as probably multifaceted, these are new therapeutics. They're quite complex. So we need to have a decent pipeline. Ana talked earlier about the grants that she's given. There needs to be that real investment in the scientific pipeline. Assuming that that's successful when we build that pipe, the next piece of the barrier I would say is manufacturing. Do we have sufficiently skilled staff? Do we have sufficiently robust manufacturing practices? So that's where I think things like the Catapult Network come to the fore. We should be helping drive skilled workforce. We should be helping drive innovation in manufacturing and by driving that innovation, hopefully you'll really drive down the cost of goods. Advanced therapies, they have a high upfront cost. However, if they're used properly, you remove all the comorbidities. You remove all this lifelong need for ongoing medication, ongoing healthcare provision. But that high cost upfund with the way that the NHS is currently funded is really quite complex. So drive down the cost of goods. I think that's a really big barrier that we need to overcome. And then I suppose driving uptake, what we've seen within the healthcare setting, these are new. So there's a resistance, this lack of training, lack of time for people to understand what they are once you get outside the tertiary centre. So we need to upscale the NHS workforce. But also we need to engage the patients with new technologies such as this. We need to hear the patient voice much more strongly. And by engaging that community, the uptake is going to be driven. We see again and again in the ATTCs, the referral pathways are influenced by socioeconomic factors, by ethnicity, language barriers, there's a whole number of barriers. So I think using technologies, using the ability we have to reach the patients and understanding and communicating with them really thoroughly will also increase the uptake. So I think multifaceted barriers that need to be tackled individually, but holistically, you can't drive down the cost of goods but not have an avenue to accelerate the uptake by patients. So I think multifaceted, Chris. So no shortage of complexity in the medicines, no shortage of complexity in the barriers. Arun, from the perspective of CPI, looking across diagnostics and medicines and health technologies, are those barriers similar or subtly different for those other technologies? I had picked two barriers, Chris, and both of them have been somewhat covered. One is clearly the barrier around manufacturing scale-up, and that is very true across the next generation medicines, as well as next generation health technologies. Many great inventions and technologies are shown usually to be working at a lab scale, but they fail if they're not systematically scaled up for manufacturing quality and volume. And this challenge applies to novel therapeutics, diagnostics, medical devices, and this is where I totally agree with Jackie. You know, catapults have a major role to play in this space in addressing this innovation value by providing access to both expertise and resources and facilities to scale up products. In HealthTech, for example, we bring together a multidisciplinary set of capabilities to allow the scaling up of diagnostics and medical devices and under appropriate ISO standards so we can make the devices and their quality and quantity to feed into clinical validation stages. The second challenge I wanted to highlight was access to finance, and Ana very clearly talked about some of the later stage financial challenges relating to adoption. I also believe there is a huge access to finance challenge during the innovation stages in its own right. As we know, some of these novel therapeutics and HealthTech products require anywhere from 8 to 15 years to commercialize after you've shown that something works at a lab scale. So these are long gestation periods. Does the UK have the right scale of private investment, for example, to go with some of the collaborative R&D grants to allow these long gestation periods? So these are real challenges many of our SME clients particularly face. A number of academic spin-offs and young small companies, they have a huge challenge around access to finance, and if they don't secure the right financing, they will struggle to take it forward. So looking across this broad spectrum of new healthcare innovations, there are no shortage of challenges from getting those inventions through to the patients who will benefit from them. And we've heard just now about digital change, about regulatory change, about reimbursement change, around access to finance, access to skills, access to manufacturing, and so on and so forth. These are not insurmountable, but they are addressable if we innovate across a range of different areas. And I'm interested to hear the panel's views on those sort of key bits of, I suppose, non-technological innovation maybe, that will increase the availability and accessibility of these new treatments to patients who really need them, not only here, but also in other areas of the world where the UK could be a test bed. Are there any non-technological innovations in parts of our healthcare system, finance system, policy systems or whatever that enable us to help move the needle in favour of the adoption of this technology and reduce those barriers? I'm just keen to hear your ideas. Anna? Well, this is a difficult question for just a clinician like myself, but I'll try. I think we need to think about diagnostics as a road to prevention. So early diagnosis, it needs a bit of technology, but not necessarily very sophisticated technology. So we have seen, to give a few examples, liquid biopsies in England, not implemented across entire UK should we have done it. Do we know whether that sort of very early diagnosis helps? Really have we done enough long-term observational analysis and studies? We probably haven't. There are other things that can happen. And this brings me to the Scottish end-to-end pathway that we've designed that Jacqueline is aware of, which we call ANIA and IDA. I explain this abbreviations. So ANIA stands for Accelerated National Innovation Adoption and IDA stands for Innovation Design Authority. We, with little money, we don't have much, brought together, team with expertise in innovation and adopting innovation to our NHS. This is focused on NHS not whole world, Chris, because NHS needs it, as you know. And then we brought senior people from government and NHS to work hand in hand, including industry representative one, to increase risk appetite, to reduce barriers, and to adopt once we decide that something is truly transformative innovation to adopt it at scale across all our health boards, entire Scottish NHS. And you would think that millions of such pathways do exist already around the world, but we've been told by people who know, that is Big Pharma colleagues, that such pathways do not exist, that this is pretty unique. So I'm hugely supportive to push that further to make it work for patients and communities. And some of these innovations will be coming back to prevention. Prevention will be a hugely important part of innovation. So for example, type 2 diabetes can now be prevented, and we can achieve remission that could save the NHS billions over time. Should we prioritise these sort of activities over other things? It's a big question for population. But that's of course not everything. Looking at mRNA vaccines that Arun mentioned, the whole area of mRNA vaccines for cancer, these very specific, this absolutely almost individual focused interventions are breathtaking, and we would like our population across UK and the world to have access to it. And the question here is how could you make it accessible to a larger number of patients once your diagnostics give you that early diagnosis, and when you can give this very highly specialized and focused treatment? Thank you, Anna. Jackie. So thinking about non-technology, which is quite difficult in this field, we tend to switch to the technology. I think some really simple approaches, clinical trials. If we increase the number of clinical trials we're running with these innovative medicines, not only does that give patients early access to these medicines, which is crucial, but also allows the NHS to become familiar with them, to get ready for the adoption of their licensed products when they become available. And that makes the UK attractive for product launch. You know, we're a sovereign regulator now. It used to be that as part of the EU, there would be a European-wide manufacturing and authorization, so the UK would by default be part of that authorization. Now, we're subtly different, so we're able to attract companies in a different way. You know, so let's get them enthused by coming here for the clinical trials and then work with them in things like the MHRA's iLAPS scheme, innovative licensing and access pathway, where you're looking at licensing, but also access and what's required for both so that the NHS is ready for that and ready to commission them. So I think that's really important. It's not technologically based. And also, in terms of clinical trials, we're already in advanced therapies. We've got representation about 9% of all global trials. That's astonishingly high. It's usually about 2% or 3%. Let's build on that. You know, if we're seen, as I said, the excellence for these trials, bring them in. Training and education, again, not awfully technology-based. You can use technology to do it. However, if you've got a skilled workforce and you've got clinicians, nurses, healthcare practitioners who are confident in using these drugs, then you're going to increase the patient access to them. And you're going to give the patients confidence to use the products, because they understand the technology and that they've been informed properly. And it was just when Anna was talking there, I started thinking slightly differently as well. I think the risk appetite, if we could just broaden that a wee bit, the risk currently always falls to the health service. These are expensive medicines, a combined diagnostic extensive. When do you bring them in? Do you bring them in really early on? However, if you think about you treat somebody with sickle cell disease and you remove all those comorbidities, they have a one-off treatment and they're out in society in a high-value manufacturing job potentially. And the economic benefit that they bring far outweighs the cost that it might have been for the NHS if it's treated appropriately. So I suppose really understanding the economic benefit of using these precise technologies early on and that risk sharing is not just the health services should be picking up, we should be looking broader. So those are some of the technology, non-technology solutions that came to mind from me. Thanks Jackie, that's great. Arun to you. I'll only make a couple of quick points. One is I still feel there's a huge level of fragmentation across the health innovation ecosystem and how might we address that in a holistic manner. More joining up and collaboration is a good starting point. I think there are some things that we can deliver some quick wins, I think. And it's not always about new technology and I made this point as well. Sometimes we can put together existing technologies in a much more pragmatic manner and demonstrate quicker results. And to a large extent, our role as catapults is to support developers of new therapies and diagnostics and other health technologies to accelerate their own development pathway. And that should then feed into clinical validation stages. And subsequently, I believe market forces and other national health priorities and policies will take over essentially. So I'll pause there, but essentially there's a big piece around convening and bringing people together and collaborating, not always reinventing. I think there's an art form in doing much more of that to see some quick wins. Can you talk to us a little bit about the importance of clinical trials and why that really matters to the UK? Yeah, I think clinical trials matter for a number of reasons for the fanta therapies. Quite often they're used to treat rare diseases. And obviously, the chance of many patients being within the UK or globally with that particular disease, there's very few patients. So therefore, when you have your clinical trial, you have to design it not only so that it's fit for purpose for regulatory purposes, but you also have to have an eye on what's required for reimbursement and what you need for your HTA. So I think that's really quite important. You do your trial once and you do it well. But as we move to higher prevalent diseases such as diabetes or cardiac issues, then you really have to consider your clinical trial. How do you do a comparison against standard of care? How do you use your data within the NHS to prove that actually there is a lifelong benefit to the patient? So I think really understanding the product and how it performs well in the clinic is important. And also, as I said earlier, providing that real knowledge of how the product should be used in the clinic only arises from using a clinical trial. That's where you learn about it. So I think here in the UK, we really need to be encouraging the use of clinical trials to bring these innovative products into the UK. And I know that myself and Anna have been having a discussion about the real requirement for it here in Scotland, for instance. Anna, I don't know whether you'd like to comment. Yes, so I agree 100% with Jacqueline that it is really essential to bring our clinicians on board and how to do it and how to do it safely at the stage of clinical trials. As you probably know, there is a big UK wide initiative to bring more commercial clinical trials to the UK. This is something we participate in wholeheartedly across the UK. Clearly, we mostly talk about large phase two clinical trials for common diseases. But Jacqueline is right that the same principle applies and should apply to rare diseases. And this is the only way we'll do it well. We do it safely and will bring great companies to the UK to get both funding and know how to our clinical systems. So absolutely agree. We will be talking extensively about commercial clinical trials over the last few months across the UK and in Scotland and everywhere else. And we want to do it better, faster, but patient centric is the most important element of this. Thank you, Anna. And yes, the implementation of the Assurgency Review will be a really important aspect of clinical development across the UK for the next years to come. Arun, any thoughts on the importance of clinical development here in the UK? Yeah, I think it's vital. And there are some excellent clinical trial capabilities in the UK, which I think is also an opportunity for attracting foreign companies to come and locate in the UK and run their trials here. So I also see it as an economic opportunity, in fact, not just societal and patient benefit. So we should be promoting more of the UK capabilities in the space. We come to our final question and short answers from you all given the time that we have today. What's the top innovation? What's the top of the tree for you as individuals in terms of the innovation that's going to make the widest impact over the next few years? What's the one thing, almost your magic wand moment that they say, if you can do this well, then you're going to make the biggest impact, Anna? Yeah, I will be a bad person and say that what we've been seeing recently, it's the AI with machine learning for imaging, for early diagnostics of lung cancer, skin cancers, mammograms. We've seen hugely promising stuff that is not replacing doctors, but helping doctors to do things faster in more efficient way and to get patients to treatment much faster and safer. So sorry, I think that if we get that one right, the whole way health services work will be improved enormously. Thank you, Anna, Jackie. I was most linked with that. I was going to say data, using our data, whether that be within our manufacturing, so that we understand our processes using technology. We really understand what's going on in those living cells and the process going on there, so that we can really drive a consistent, efficacious product that is produced more cheaply. And then using the data within the health service, we've got this wealth of data. How can we tap into that to prove that actually, the products do have lifelong persistence? And if it is a precise medicine for a particular patient, proof indeed that that precision did work, and using that data to perhaps come back to the topic about regulatory, can you approve platforms of products by using the wealth of data that we have out there? So I think data. Thank you. Arun. I believe in perhaps the bit more cliche prevention is better than cure and care. So for me, more support for populations to be educated on healthy lifestyle choices will probably go a much, much longer way in delivering a wider impact on human health as well as planetary health. Having said that, I do believe early diagnostic technologies could be a big game changer. And again, Anna referred to this, particularly technologies like liquid biopsy, how might we really enable the full potential of such powerful approaches to very early diagnostic technologies? Thank you. And thank you all for joining me to discuss some of the future of healthcare driven by innovation and the adoption of that innovation, which will be impactful and make a difference. We've heard about precision medicine. We've heard that that is leading to preventative medicine, evidence based scale that pandemic paced, deployed early by workforces with new skills, including many of those being digital skills, and a purposeful collaboration in a three way mode between the health systems, industry and academia to drive adoption at scale, and then report back to the system with pace. You've heard also from Catapult colleagues about their working at multiple levels, supporting inventors, supporting SMEs, supporting larger companies, supporting healthcare systems, supporting investors in this really important community, helping all of them help health systems and industrialists help us as today's patients and future patients. Thank you all very much indeed for your attention today to Dame Anna, to Jackie and to Arun and to all of you for listening. Thank you, Chris. I've really enjoyed this healthy debate, which identified so many pathways for successfully evolving UK healthcare through innovation to make a real impact. We must shorten development time from lab to patient drive down the cost of health innovations and move the dial from treatment towards prevention through data and diagnostics. We also heard about the importance of clinical trials, targeted application of data and AI and the need for better education on healthy lifestyle choices, evolving UK healthcare through science, innovation and technology has the power to improve and extend our lives. I hope you enjoyed this episode of the Catapult Network Supercharging Innovation podcast. Episodes are available wherever you get your podcasts. If after listening to this episode you have questions and suggestions or simply want to sell us your ports, do get in touch with us via social media, through our website catapult.org.uk or via your podcast app. Help us put UK innovation under the spotlight. Subscribe now.